title: Implementing a patient education intervention about Methicillin-resistant Staphylococcus aureus prevention and effect on knowledge and behavior in veterans with spinal cord injuries and disorders: a pilot randomized controlled trial.
abstract: OBJECTIVE
  To assess the feasibility and effect of a nurse-administered patient educational intervention about Methicillin-resistant Staphylococcus aureus (MRSA) prevention on knowledge and behavior of Veterans with spinal cord injuries and disorders (SCI/D).
  
  
  METHODS
  Blinded, block-randomized controlled pilot trial.
  
  
  METHODS
  Two Department of Veterans Affairs (VA) SCI Centers.
  
  
  METHODS
  Veterans were recruited March-September 2010 through referral by a healthcare provider from inpatient, outpatient, and residential care settings.
  
  
  METHODS
  Thirty participants were randomized to the nurse-administered intervention and 31 to the usual care group. The intervention included a brochure and tools to assist nurses in conducting the education.
  
  
  METHODS
  Pre- and post-intervention measurement of knowledge and behaviors related to MRSA and prevention strategies and feasibility measures related to implementation.
  
  
  RESULTS
  Participants were primarily male (95.1%), white (63.9%), with tetraplegia (63.9%) and mean age and duration of injury of 64.3 and 20.5 years, respectively. The intervention groups mean knowledge score significantly increased between pre- and post-test (mean change score = 1.70, 95% confidence interval, CI 0.25-3.15) while the usual care groups score did not significantly change (mean change score = 1.45, 95% CI -0.08-2.98). However, the mean knowledge change between intervention and usual care groups was not significantly different (P = 0.81). Overall behavior scores did not significantly differ between treatment groups; however, the intervention group was more likely to report intentions to clean hands (90.0% vs. 64.5%, P = 0.03) and asking providers about MRSA status (46.7% vs. 16.1%, P = 0.01). Nurse educators reported that the quality of the intervention was high and could be implemented in clinical care.
  
  
  CONCLUSIONS
  A targeted educational strategy is feasible to implement in SCI/D clinical practices and may improve some participants' knowledge about MRSA and increase intentions to improve hand hygiene and engagement with providers about their MRSA status.
authors.forename: Charlesnika T
authors.initials: CT
authors.lastname: Evans
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Hill
authors.forename: Marylou
authors.initials: M
authors.lastname: Guihan
authors.forename: Amy
authors.initials: A
authors.lastname: Chin
authors.forename: Barry
authors.initials: B
authors.lastname: Goldstein
authors.forename: Michael S A
authors.initials: MS
authors.lastname: Richardson
authors.forename: Vicki
authors.initials: V
authors.lastname: Anderson
authors.forename: Kathleen
authors.initials: K
authors.lastname: Risa
authors.forename: Susan
authors.initials: S
authors.lastname: Kellie
authors.forename: Kenzie A
authors.initials: KA
authors.lastname: Cameron
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000472:pathogenicity*; D008875:Middle Aged; D010353:Patient Education as Topic; D010865:Pilot Projects; D013119:Spinal Cord Injuries / Q000150:complications*; D013203:Staphylococcal Infections / Q000517:prevention & control*; D014728:Veterans / Q000193:education*
keywords: Methicillin-resistant staphylococcus aureus; Patient education; Spinal cord injury